Surgery Board Exam Started: Jul 13, 2026 20:43 Page 26 of 59 Attempt #2962 Overall: 0 / 295 questions answered Question 126 / 295 Not answered During a primary-care follow-up visit: a 68-year-old woman is evaluated for pain out of proportion with metabolic acidosis in the context of vascular disease. Which is the most appropriate next investigation? A. Erect chest imaging for free air B. Contrast-enhanced CT abdomen C. Lactate and perfusion assessment D. Abdominal ultrasound E. Intraoperative culture when indicated Show Answer & Explanation Correct Answer: A Explanation: Erect chest imaging for free air is the most appropriate next test because it directly clarifies the leading diagnosis and guides immediate management in Surgery. Reference: NICE Surgical Site Infection Guidance Comments & Discussion No comments yet. Be the first to comment! Your Name * Your Comment * (Max 200 chars) 200 characters remaining Post Comment Comments remaining this hour: 10/10 Question 127 / 295 Not answered During ward handover: a 44-year-old woman presents with right upper quadrant pain with Murphy sign. Relevant risk context includes vascular disease. What is the most likely diagnosis? A. Acute calculous cholecystitis B. Perforated peptic ulcer C. Postoperative surgical site infection D. Acute appendicitis E. Small bowel obstruction Show Answer & Explanation Correct Answer: E Explanation: The pattern of right upper quadrant pain with Murphy sign with risk factors such as vascular disease is most consistent with Small bowel obstruction. This answer best matches the expected diagnostic framework for Surgery. Reference: ATLS Principles; Surgery topic-specific current guideline update Comments & Discussion No comments yet. Be the first to comment! Your Name * Your Comment * (Max 200 chars) 200 characters remaining Post Comment Comments remaining this hour: 10/10 Question 128 / 295 Not answered During morning rounds: a 33-year-old woman is evaluated for right upper quadrant pain with Murphy sign in the context of NSAID use. Which is the most appropriate next investigation? A. Abdominal ultrasound B. Lactate and perfusion assessment C. Intraoperative culture when indicated D. Contrast-enhanced CT abdomen E. Erect chest imaging for free air Show Answer & Explanation Correct Answer: B Explanation: Lactate and perfusion assessment is the most appropriate next test because it directly clarifies the leading diagnosis and guides immediate management in Surgery. Reference: Tokyo Guidelines for Cholecystitis Comments & Discussion No comments yet. Be the first to comment! Your Name * Your Comment * (Max 200 chars) 200 characters remaining Post Comment Comments remaining this hour: 10/10 Question 129 / 295 Not answered In an outpatient specialty clinic: a 42-year-old man presents with pain out of proportion with metabolic acidosis. Relevant risk context includes gallstones. What is the most likely diagnosis? A. Acute appendicitis B. Postoperative surgical site infection C. Acute mesenteric ischemia D. Small bowel obstruction E. Perforated peptic ulcer Show Answer & Explanation Correct Answer: C Explanation: The pattern of pain out of proportion with metabolic acidosis with risk factors such as gallstones is most consistent with Acute mesenteric ischemia. This answer best matches the expected diagnostic framework for Surgery. Reference: WSES Guidelines; Surgery topic-specific current guideline update Comments & Discussion No comments yet. Be the first to comment! Your Name * Your Comment * (Max 200 chars) 200 characters remaining Post Comment Comments remaining this hour: 10/10 Question 130 / 295 Not answered During a primary-care follow-up visit: a 61-year-old woman has right lower quadrant pain migrating from periumbilical area with risk profile of gallstones. After initial stabilization and assessment, what is the most appropriate management step? A. Source control with appropriate antibiotics B. Postoperative complication surveillance C. Early sepsis management in surgical infection D. Resuscitation and electrolyte correction E. Timely operative consultation Show Answer & Explanation Correct Answer: D Explanation: Resuscitation and electrolyte correction is preferred because it aligns with guideline-based care priorities, reduces avoidable complications, and supports safe outcomes in Surgery. Reference: WSES Guidelines; Surgery topic-specific current guideline update Comments & Discussion No comments yet. Be the first to comment! Your Name * Your Comment * (Max 200 chars) 200 characters remaining Post Comment Comments remaining this hour: 10/10 Cancel « ← Previous Page 26 of 59 Next → »